But the CRS report, requested by Republicans on the Senate Health, Education, Labor and Pensions Committee, says that statement "is not a formal policy issuance" even if "it is reasonable to conclude that HHS intends on issuing regulations formalizing this stated policy."

In a letter to HHS Secretary Kathleen Sebelius, the senators request that the agency issue such regulations as soon as possible.

"Absent such contractual requirements," they write, "it will be necessary for Congress to modify the current law to include restrictions to prevent federal dollars from being used to provide such coverage. We request that you identify the specific actions and timeline you will take to address these concerns by July 30, 2010."